Meta-analysis: diagnostic accuracy of coronary CT angiography with prospective ECG gating based on step-and-shoot, Flash and volume modes for detection of coronary artery disease.
Eur Radiol 2014;
24:2345-52. [PMID:
24865695 DOI:
10.1007/s00330-014-3221-y]
[Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 03/28/2014] [Accepted: 05/06/2014] [Indexed: 12/27/2022]
Abstract
OBJECTIVES
To investigate the diagnostic performance of coronary computed tomographic angiography (CCTA) with prospective electrocardiograph (ECG) gating based on step-and-shoot (SAS), Flash and volume imaging modes.
METHODS
We searched the electronic databases PubMed for all published studies regarding CCTA. We used an exact binomial rendition of the bivariate mixed-effects regression model developed for synthesis of diagnostic data.
RESULTS
A total of 21,852 segments, 4,851 vessels and 1,375 patients were identified using database searches. Patient-level pooled sensitivity was 0.99 (95 % confidence interval [CI], 0.98-1.00); specificity was 0.88 (CI, 0.85-0.91). The results showed that the sensitivity and specificity for detection of significant stenosis did not differ in the three protocols (P = 0.24). No heterogeneity was found at the patient level for sensitivity (Q = 26.23; P = 0.12; I (2) = 27.56 % [CI, 0.00-67.02 %]) and specificity (Q = 19.54; P = 0.42; I (2) = 2.78 % [CI, 0.00-66.26 %]).
CONCLUSIONS
CCTA with prospective ECG gating has similar high diagnostic value to rule out CAD in all three presented modes.
KEY POINTS
• The accuracy of CCTA with different prospective ECG gating is similar • CCTA with prospective ECG gating is effective to exclude coronary artery disease • The radiation dose of volume mode increases with higher heart rate.
Collapse